title: Career plans of current orthopaedic residents with a focus on sex-based and generational differences.
abstract: BACKGROUND
  An orthopaedic workforce shortage has been projected. The purpose of this study is to analyze the supply side of this shortage by ascertaining the career plans of current orthopaedic residents, comparing these plans with the career patterns of practicing orthopaedists, and identifying career-plan differences according to sex.
  
  
  METHODS
  An online, self-administered survey was e-mailed to U.S. orthopaedic residents in postgraduate year three or higher, querying them about their fellowship specialty choice and their career plans.
  
  
  RESULTS
  A total of 498 residents completed the online survey; 430 respondents (86%) were male, sixty-three (13%) were female, and five (1%) did not provide information regarding sex. Ninety-one percent of the residents were planning to enroll in a fellowship, with some respondents indicating more than one subspecialty choice: 28% intended to choose sports; 21%, arthroplasty; 14%, hand surgery, 12%, trauma; 8%, pediatrics; 8%, shoulder and elbow surgery; 8%, spine surgery; 6%, foot and ankle surgery; and 2%, oncology. With regard to the top career priorities of residents in selecting a fellowship specialty, 40% indicated intellectual priorities; 36%, educational; 21%, lifestyle; and 4%, economic. Significantly more women than men were planning on pursuing a pediatric fellowship (24% versus 6%, respectively, p < 0.05) and significantly fewer were planning on pursuing a sports fellowship (11% versus 31%, respectively, p < 0.05). Significantly more women than men planned on a subspecialty-only practice (62% versus 34%, respectively, p < 0.05). The projected retirement age of sixty-four years for current residents is roughly equal to that of the previous generation. There was no difference between men and women with regard to leadership and research aspirations, projected retirement age, and projected workdays per week. However, significantly more women than men (65% versus 47%, respectively) planned on reducing their work hours or changing to part-time status at some time during their careers. There is a higher percentage of female residents (13%) than female practicing orthopaedists (4%) in the United States.
  
  
  CONCLUSIONS
  We should continue efforts to collect workforce data and be proactive to avert or minimize the effect of impending orthopaedic workforce shortages on our patients. Given the trend toward an increasing proportion of female orthopaedists and the higher likelihood that they will reduce their work hours during portions of their career, policymakers should consider training more orthopaedists to ensure patient access to timely, quality orthopaedic care.
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, White 535, Boston, MA 02114, USA. sanaz@post.harvard.edu
authors.forename: Sanaz
authors.initials: S
authors.lastname: Hariri
authors.forename: Sally C
authors.initials: SC
authors.lastname: York
authors.forename: Mary I
authors.initials: MI
authors.lastname: O'Connor
authors.forename: Brian S
authors.initials: BS
authors.lastname: Parsley
authors.forename: Joseph C
authors.initials: JC
authors.lastname: McCarthy
mesh_terms: D000328:Adult; D000367:Age Factors; D002321:Career Choice; D003625:Data Collection; D004503:Education, Medical, Graduate; D005257:Fellowships and Scholarships; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009985:Orthopedics / Q000193:education*; D012737:Sex Factors; D014481:United States; D000078329:Workforce